Provider Demographics
NPI:1831633114
Name:SCHWARZKOPF, KELSEY J
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:J
Last Name:SCHWARZKOPF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59230 ANNAH DR
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-9404
Mailing Address - Country:US
Mailing Address - Phone:248-292-1250
Mailing Address - Fax:
Practice Address - Street 1:59230 ANNAH DR
Practice Address - Street 2:
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-9404
Practice Address - Country:US
Practice Address - Phone:248-292-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other